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West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 148 Chapter 1 Application/Redetermination Process

verification is required after the complete application is received, the Worker must request it immediately to allow the client at least 10 days to provide it. When a DFA-2 is used, the application for Medicaid coverage as a pregnant woman must be approved within 13 business days of the date a complete application is received, even though the application for another program may not require faster processing. Eligibility system action must be taken to deny or withdraw the application within 30 days of the date of application if the application cannot be approved. 1.9.3 BEGINNING DATE OF ELIGIBILITY 1.9.3.A Application while Pregnant The beginning date of eligibility is the first day of the month of application, if eligible. Eligibility may be backdated up to three months prior to the month of application, provided all eligibility requirements were met. 1.9.3.B Application after Pregnancy Ends When the client applies within three months of the termination of the pregnancy, eligibility may be backdated up to three months, prior to the month of application, in which she met all eligibility requirements. 1.9.4 REFERALS TO THE OFFICE OF MATERNAL CHILD AND FAMILY HEALTH (OMCFH) When the pregnant woman's application is denied for any reason, or a WVCHIP or children’s Medicaid application is denied when a child is pregnant, a referral is made to the OMCFH. A list of these denied applications is generated by the eligibility system and made available to the OMCFH. This permits OMCFH to evaluate the client for other available government-sponsored health care.

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Page 181

Official source

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 148 Chapter 1 Application/Redetermination Process

verification is required after the complete application is received, the Worker must request it immediately to allow the client at least 10 days to provide it. When a DFA-2 is used, the application for Medicaid coverage as a pregnant woman must be approved within 13 business days of the date a complete application is received, even though the application for another program may not require faster processing. Eligibility system action must be taken to deny or withdraw the application within 30 days of the date of application if the application cannot be approved. 1.9.3 BEGINNING DATE OF ELIGIBILITY 1.9.3.A Application while Pregnant The beginning date of eligibility is the first day of the month of application, if eligible. Eligibility may be backdated up to three months prior to the month of application, provided all eligibility requirements were met. 1.9.3.B Application after Pregnancy Ends When the client applies within three months of the termination of the pregnancy, eligibility may be backdated up to three months, prior to the month of application, in which she met all eligibility requirements. 1.9.4 REFERALS TO THE OFFICE OF MATERNAL CHILD AND FAMILY HEALTH (OMCFH) When the pregnant woman's application is denied for any reason, or a WVCHIP or children’s Medicaid application is denied when a child is pregnant, a referral is made to the OMCFH. A list of these denied applications is generated by the eligibility system and made available to the OMCFH. This permits OMCFH to evaluate the client for other available government-sponsored health care.